| Title: |
The Influence of Surgical Teaching on Laparoscopic Cholecystectomy Outcomes : A Retrospective Propensity Score-Matched National Cohort Study |
| Authors: |
Rodrigues Ribeiro, Joana; Silva Alves, André Quang; Probst, Pascal; Käser, Samuel A.; Toso, Christian; Moeckli, Beat |
| Source: |
ISSN: 1878-7452 ; Journal of surgical education, vol. 82, no. 11 (2025) 103744. |
| Publication Year: |
2025 |
| Collection: |
Université de Genève: Archive ouverte UNIGE |
| Subject Terms: |
info:eu-repo/classification/ddc/617; Cholecystectomy; Education; Global surgery; Laparoscopy; Residency; Training |
| Description: |
Background: Teaching in the operating room represents the cornerstone of surgical education. While residents need to perform enough basic procedures to gain independence, their impact on outcomes remains debated. Method: We conducted a retrospective study using a Swiss national registry between 2009 and 2019. Patients who underwent laparoscopic cholecystectomy were identified. Baseline characteristics were analyzed, and a propensity score was constructed using age, gender, American Society of Anesthesiologists (ASA) classification, workday status, operation setting, and surgical indication. Patients were then matched in a 2:1 ratio (non-teaching vs. teaching), and surgical outcomes were assessed. The primary outcome was safety, defined by the incidence and severity of postoperative complications. Results: We included 34,080 cholecystectomies in our analysis. After propensity-score matching, 7038 interventions used for surgical teaching were compared to 14,076 performed by board-certified surgeons. Mean cohort age was 53 years, and 7.7% of patients had an ASA>II. Our analysis found comparable safety outcomes in regard to frequency (1.5 vs. 1.6%, p = 0.5) and severity (Clavien-Dindo ≥IIIa: 42.0 vs. 42.7%, p = 0.8) of postoperative complications. The teaching group had a longer mean operating time (85 ± 38 vs. 73 ± 44 minutes, p < 0.001), while the mean postoperative LOS was comparable between groups (3.70 ± 5.64 days). Multivariate regression analysis identified older age, ASA ≥III, weekend days, and urgent setting as independent negative predictors of teaching. Conclusion: Teaching residents a common surgical procedure, such as cholecystectomy appears safe, with equally low complication rates and severity, despite longer operative times. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/41072245; unige:191823 |
| Availability: |
https://archive-ouverte.unige.ch/unige:191823 |
| Rights: |
info:eu-repo/semantics/openAccess |
| Accession Number: |
edsbas.DAA0420D |
| Database: |
BASE |